Results of the One-Anastomosis Gastric Bypass (OAGB): Safety, Nutritional Considerations and Effects on Weight, Co-Morbidities, Diabetes and Quality of Life

Abstract

Morbid obesity is a chronic, progressive, relentless and multifactorial disease leading to catastrophic repercussions for the patient. Although surgery is currently the only effective alternative in its treatment, the “ideal” bariatric operation is yet to be found. After performing many of the available open and laparoscopic options in bariatric surgery, and aware of several issues with the Roux-en-Y gastric bypass which we were performing at the time, we decided to evaluate the Mini-gastric bypass (MGB) which had recently been reported. The laparoscopic One-Anastomosis Gastric Bypass (OAGB) was thus created in the year 2002, as a modification of the MGB with differentiated conceptual principles and technical features. Since then, we have periodically reported our outcomes both in scientific meetings and publications. This chapter updates our experience with a prospectively collected database of now 3000 patients during a 15 year period.

Demographics included age: 43 y.(12–74), BMI: 46 (31–86) and EBW: 65 kg (28–220). There were 4 (0.13%) conversions. Length of stay for uncomplicated patients (99%) was 24 h. (15–120) and 9 days (4–32) for those with major complications. These prompted further operations in 23 (0.9%) and were solved conservatively in 12 (0.4%). Long-term complications occurred in 83 (2.8%). There were three deaths (0.1%) due to PTE, nosocomial pneumonia and DIC. Postoperative %EWL was 84%, 81%, 77%, 70% and 70% at 1,3,5,10 and 15 years, respectively. Overall total or partial resolution of co-morbidities was achieved in 97% and 92% at 2 and 15 years, respectively. Quality of life (GIQoLI) was satisfactory in all parameters assessed postoperatively.

OAGB provides reduced difficulty and very low morbidity-mortality. Long term %EWL and co-morbidity resolution are similar to the best results obtained with more aggressive and complex operations. OAGB has established itself as one of the safest and more effective alternatives in bariatric surgery.

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Authors and Affiliations

Enrique Luque-de-León

1

2

Miguel A. Carbajo

1

1.Center of Excellence for the Study and Treatment of Obesity and DiabetesValladolidSpain

2.Center of Excellence for the Study and Treatment of Obesity and Diabetes—Latinamerican Affiliated Subsidiary/The American British Cowdray Medical Center, I.A.P. /Hospital de Especialidades—Centro Médico Nacional (IMSS)México CityMexico